1. Noncoliform lactose -negative enterics 2011274015 이예진 ( 발표,PPT 제작 ) 2011274014 오경진 ( 자료수집, 자료정리 ) 2011274016 서유진 ( 자료수집, 자료정리 ) 2011274018 이은송 ( 자료수집,QUIZ)

2. Contents Noncoliform Opportunists -Proteus, Morganella, Providencia True pathogens -Salmonella, Shigella Salmonella -S. typhi -Typhoid fever -Animal salmonelloses Shigella -Shigellosis

3. Noncoliform Non-lactose-fermenting or slow lactose- fermenting bacteria

4. Opportunists &True pathogens Opportunists - 기회감염균 -Proteus, Morganella, Providencia True pathogens - 감염 시 무조건 질병을 유발하는 균 -Salmonella, Shigella

5. Opportunists -Saprobes in soil, manure, sewage, and polluted water Commensals of humans and other animals. -Widespread distribution, but harmless to a healthy individual.

6. Opportunists Proteus -wavelike swarming pattern in a moist agar Morganella Providencia urinary tract infection, wound infection, pneumonia, septicemia, and occasionally infant diarrhea

7. True pathogens Well-developed virulence factors Primary pathogens Not being normal residents of humans Salmonella → Salmonelloses Shigella → Shigellosis

8. Salmonella Flagella Grow readily on most laboratory media Survive outside the host in environments Resistant to bile and dyes Do not lose virulence after long-term artificial cultivation

9. S. cholerae-suis & S. enterica S. cholerae-suis -zoonosis of swine S. enterica - 2,300 different serotype : based on variations on the major O, H Vi antigens - S. Typhimurium, S. Newport

10. S. typhi Morphology - small, motile gram(-) rod Habitat -humans are the exclusive hosts

11. S. typhi Virulence factor - LPS endotoxin - enterotoxin - capsule (referred to as the Vi antigen) → increase infectivity - Antibiotic resistance Disease -Typhoid fever

13. Typhoid fever Infection a. enters canal by contaminated water or food & personal contact b. adhere the mucosa of the small intestine →progressive and invasive infection & secrete enterotoxin→ septicemia

14. Typhoid fever

16. Symptoms - ulceration that are vulnerable to hemorrhage, perforation, peritonitis→ nodules or abscesses in the liver or urinary tract

17. Typhoid fever Diagnosis -preliminary diagnosis patient’s history and presenting symptoms, supported by a rising antibody titer -Definitive diagnosis isolation of the S.typhi

18. Typhoid fever Prevention -oral vaccine, capsular polysaccharide -good sanitation practices Treatment - ciprofloxacin or ceftriaxone -Surgical removal of the gallbladder (chronic inflammation) -Convalescence

19. Outbreaks Typhoid Marry

20. http://www.youtube.com/watch?v=tyHpLdq OX5shttp://www.youtube.com/watch?v=tyHpLdq OX5s

21. Animal Salmonelloses Salmonella food poisoning, Salmonella gastroenteritis S. paratyphi A, S.paratyphi B, S.paratyphiC, S. typhimurium Zoonotic in origin

23. Animal Salmonellosis Infection factors - poorly cooked meat products and eggs - unpasteurized milk, ice cream, and cheese -Foods contaminated by rodent feces Symptoms -moderate fever, nausea -abdominal pain and cramps -diarrhea

25. Animal Salmonelloses Diagnosis Isolation the pathogen →cultivation on media →ELISA test →DNA probes

26. Animal Salmonelloses Prevention -In the kitchen : good sanitation practices, sufficient cooking -While traveling : do not use tap water -community measures: water purification, pasteurization of milk, restriction of carriers from food handling Treatment -normally, recovery will be complete in a few days

28. Typhoid fever Gastroenteritis Asymptomatic infection

29. Shigella Non motile Non capsular Non spore former Not fastidious Resemble some types of pathogenic E.coli habitat only in humans, apes, and monkeys

30. Shigella Primarily human pathogens -S.dysenteriae : severest form of dysentery and prostration least common species, developing countries -S.sonnei : a mild form of dysentery(least severe) common species, developed countries -S.flexneri : common species -S.boydii

31. Shigellosis Bacillary Dysentery Infection factor -Five F’s: feces →food, fingers, flies, fomites - Direct person to person - Circumstance such as malnutrition, crowding, day care centers, military camps and prisons

33. Shigellosis Infection a.Proliferate to immense numbers in the small intestine, but cause damage to the large intestine b.Destroy tissue in the intestinal mucosa by means of lymphoid cells in Peyer’s patches (cf. S.dysenteriae – invade the blood steam)

34. Shigellosis c.Release endotoxin → fever enterotoxin → mucosa and villi exotoxin (shigatoxin) : S.dysenteriae d.Bleeding and heavy mucus secretion

35. Shigellosis * Shiga toxin : produced by S.dysenteriae -a heat labile exotoxin -inhibit protein synthesis -injury to nerve cells -damage to the intestine and the kidneys Symptoms -Crippling abdominal cramps -Severe diarrhea with blood and mucus

36. Shigellosis Prevention -The same steps as for salmonellosis -No vaccine Treatment - Fluid and electrolyte replacement -ciprofloxacin and sulfatrimethoprim(SxT) (drug resistance →ampicillin or cephalosporins)

37. Summary SalmonellaShigella MorphologyFlagella → motileNonmotile DiseaseTyphoid feverAnimal Salmonelloses Shigellosis Symptomsdiarrhea, abdominal pain High feverModerate fever PreventionGood sanitation practices TreatmentAntibiotics, Surgical removal Antibiotics, Fluid and electrolyte replacement

38. SalmonellaShigella invasionInvade the small intestineInvade the large intestine Enter the blood, lymph node, and the other organs Enter the lymphoid cells (cf. S.dysenteriae) Enterotoxin, endotoxin, cytotoxinEnterotoxin, endotoxin, exotoxin(shigatoxin)

39. QUIZ

40. Which is not true about oppotunists? ① Proteus, Morganella, Providencia are belong to opportunists. ② They are saprobes in soil, manure, sewage, etc. ③ They must cause a disease when they exist in intestine. ④ They cause urinary tract infection, pneumonia, septicemia, etc.

41. Which are the characteristics of the typhoid fever? ① Its symptoms are high fever, rose spots, and diarrhea. ② It can’t be prevented by vaccines. ③ In chronic inflammation, surgical removal of the gallbladder is required. ④ Its reported cases are increasing steadily.

42. Which of the following is not animal salmonelloses? ① It is zoonotic in origin. ② It is caused by uncooked meat or eggs, unpasteurized milk, ice cream and cheese. ③ It can be prevented by good sanitation practices. ④ Its mortality is high.

43. Which is not correct about Shigella? ① It resemble some types of pathogenic E.coli. ② It is motile. ③ It habitat only human, apes, and monkeys. ④ It can cause severe diarrhea with blood and mucus.

44. What is toxin produced by S.dysenteriae which inhibit protein synthesis? Shigatoxin

45. What are the truth of salmonellosis and shigellosis? a. Their symptoms are diarrhea and abdominal pain. b. They mostly invade and damage the small intestine. c. They can be prevented by vaccines. d. They are caused by enterotoxin and endotoxin. ① a, b ② a, c ③ a, d ④ a, b, d ⑤ b, c, d

46. Reference Foundations in MICROBIOLOGY/Talaro Chess/McGraw Hill/8 판 MICROBIOLOGY AN INTRODUCTION/Tortora, Funke, Case/Benjamin Cummings/6 판 대학미생물학 / 민경희 외역 / 탐구당 /8 판

47. Thank you